Tumescence is not a form of liposuction, it is the placement of fluid in the subcutaneous space BEFORE liposuction is performed to facilitate the removal of the fat. Here is the definition of tumescence: tumescence is the quality or state of being tumescent or swollen.
The tumescent fluid is a dilute isotonic sterile solution in which epinephrine and a local anesthetic have been added. It SWELLS the tissue before the procedure. There are many options available when choosing liposuction, but they all involve some form of tumescence fluid being placed prior to the procedure.
There is minimal pain from liposuction procedures and recovery is usually rapid. Here are other variables involved when evaluating and comparing liposuction:
- Type of liposuction performed (Laser, Vaser, Power-assisted, Water-assisted, Ultrasonic, Traditional, etc.)
- Anesthetic (General, local with sedation, local with no sedation)
- Areas to be treated
- Training and experience of the surgeon (does he/she have hospital privileges to perform liposuction)
- Safety of the surgery center where the procedure will be performed (Accredited facility with board certified anesthesia coverage)
A well trained surgeon should be able to offer all the variables listed above.
If your doctor insists on only one method of treatment I would be wary of the training and expertise and would obtain a second opinion and please do your homework. This is still a major procedure with risks and complications. (David Finkle, MD, Omaha Plastic Surgeon)
Tumescent liposuction is as uncomfortable as a few small pin pricks
Once the initial numbing injections are done it really is remarkably comfortable. It would be highly unusual to need general anesthesia along with this. In fact many patients who come back to have an additional area operated on, often choose to even forgo the mild sedation we offer.
Excellent operative assistants assure comfort, and light conversation throughout the procedure,helps the time go by quickly. (Christopher J. Peers, MD, South Bend Facial Plastic Surgeon)
Pain during tumescent liposuctiion
There should be no pain during surgery. I perform all liposuctions except for the most minor procedures under intravenous sedation. I would not employ general anesthesia, with intubation, for this procedure. It is unnecessary and produces a longer recovery.
Personally, I never encourage a patient to return to work 72 hours after surgery. It may be possible for some individuals but others are not ready, particularly given the stresses of commuting in New York City.
I would rather anticipate a week off from work than to create an expectation that may be erroneous and place a patient’s job in jeopardy. Liposuction isn’t very painful postoperatively but there will be swelling.
Pain can be controlled by oral medication. Compression garments are useful in reducing swelling which, in turn, reduces pain. (Robert L. Kraft, MD, FACS, New York Plastic Surgeon)
Tumescent liposuction is painless under general anesthesia
We often use general anesthesia during tumescent liposuction, particularly for more stubborn areas along the hip and flank. Also anesthesia is nice when multiple areas are involved to eliminate any pain or pricking. Liposuction by tumescent techniques result in about a weekend of recovery though you will need to wear a compression garment for several weeks.
Many discourage general anesthesia, possibly because of cost, but safety is not an issue in an accredited facility. (Peter E. Johnson, MD, Chicago Plastic Surgeon)
Tumescent liposuction is performed under only local anesthesia. General anesthesia has risks, and downtime and recovery may be increased. The size of the cannulas used, the number of areas being treated, and the amount of fat removed all can affect downtime.
As I only perform liposuction using local anesthesia, patients WALK out of the room following the procedure and can resume daily activities in 1-3 days, and aerobic activities by 1 week.
Addressing the procedure with your physician, including recovery time, is also prudent. (Melanie D. Palm, MD, San Diego Dermatologic Surgeon)
The pain should be similar in 4-6 hours after the procedure. Take pain medication and you should be comfortable. (Vivek Bansal, MD, Danville Plastic Surgeon)
Even if you are having procedure under general anaesthetic, using tumescence technique helps reduce postoperatvie pain and the recovery is much more comfortable. (Sanjay Parashar, MD, Dubai Plastic Surgeon)
If you are having tumescent liposuction under general anesthesia, you won’t experience pain while sedated. However, I will say that tumescent liposuction is normally done under IV sedation because it is considered safer, you’ll experience less recovery, and patients experience less side effects (nausea, vomiting) from IV sedation. (Peter Schmid, DO, FAACS, Longmont Facial Plastic Surgeon)
No pain during tumnescent liposuction and general anesthesia
There is no pain when surgery is done under general anesthesia. You are asleep for the whole procedure and have amnesia of the event.. If tumnescent fluid is placed in your tissues, as it is nearly universally in liposuction cases, some remains after the liposuction is done and that will give you about 2.5 hours of pain relief after you wake up.
Then any discomfort is easily controlled by oral pain medications, iced compresses to the areas treated and compressive garments worn after surgery. The larger the areas treated the more discomfort there is.
Having said that, if only small areas are to be treated a patient can have a very enjoyable experiance using only some sedation and the tumnescent fluid injected in the areas to be done.
This lowers the cost as no anesthesiologist is required. (Jeffrey M. Darrow, MD, Boston Plastic Surgeon)
Tumescent Liposuction with General Anesthesia
Tumescent liposuction is the instillation of tumescent fluid, (IV fluid, lidocaine, and epinephrine). The lidocaine decreases pain. The epinephrine reduces bruising and bleeding. There is no pain during general anesthesia. There may be some soreness after the procedure.
This soreness depends on how much liposuction you are doing, and other factors. It is usually well tolerated. (Jeffrey J. Roth, MD, FACS, Las Vegas Plastic Surgeon)
When tumescent liposuction is performed under general anesthesia you will experience no pain during the procedure. After the procedure, you may experience some discomfort depending on where the lab section was performed and how much tissue is removed.
In our practice, patients typically are able to control the discomfort with Tylenol and a small number of pain pills. Our patients also wear a garment immediately after liposuction which they state gives them added support and comfort. (Pat Pazmino, MD, FACS, Miami Plastic Surgeon)
Minimal Pain and Minimal Downtime
Liposuction is one of the least painful procedures and anesthesia certainly reduces this. There will be some soreness later that pain medication usually reduces. Consider Vaser Liposuction as it tends to be less painful in our hands versus tumescent liposuction alone. (Charles Perry, MD, Sacramento Plastic Surgeon)
I prefer performing liposuction with some kind of sedation, because whether or nor tumescent fluid is used, it is always more comfortable for the patient. If the patient is comfortable and not moving around too much, I do much better work.
Post-procedure the amount of discomfort for the patient is about the same. (Steven Wallach, MD, New York Plastic Surgeon)
There is no pain during the procedure since you are asleep. After the surgery there is some discomfort from the mechanical trauma during the procedure. Most patients complain of a soreness in the areas treated.
The discomfort is similar to a tough workout. In my experience, most patients are back to work within a few days. With this technique, there is generally less bruising. (Robert M. Wald, Jr., MD, Orange County Plastic Surgeon)
Pain is not a big component of liposuction
The vast majority of our Santa Rosa liposuction patients feel only modest pain, whether done under general anesthesia or sedated. We use a small amount of lidocaine in the tumescent fluid and we are careful with the suction.
That way we ensure minimal bruising and minimal swelling, which leads to a minimal-pain recovery. (Francisco Canales, MD, Santa Rosa Plastic Surgeon)
Pain with Tumescent Anesthesia
There should be no pain during the procedure with general anesthesia and minimal discomfort under local anesthesia (with sedation). Post operatively the pain is moderate and most patients say that it is tolerable with pain medication.
Usually, when smaller areas are to be addressed they can be done under local anesthesia with mild sedation and have less pain, but that is a function again of the volume. I do feel that laser assisted liposculpture/lipolysis, which is meant for mild to moderate areas of lipodystrophy (fatty accumulation) does have less bleeding, less swelling, less bruising, and less post operative pain and for a shorter period of time. (Theodore Katz, MD, FACS, Philadelphia Plastic Surgeon)
Recovery from liposuction varies
In my experience, this varies tremendously among individuals and among the areas and the extent of liposuction performed. For example, it seems that patients complain more about their “love handles” than their stomachs when the liposuction is performed around the waist area.
Generally, if you are having a few areas treated on Friday, your surgeon may apply dressings that shold remain on unitl Monday. You may requrie an examination at that time and would not be able to return to work immediately until the dressings/garments are chnaged. But it is possible, you could return to work later that day. (Otto Joseph Placik, MD, Chicago Plastic Surgeon)